Stop Oxevision

On 14th January 2026, Stop Oxevision submitted a formal complaint to Oxford Health NHS Trust regarding what appeared to be the “irrational and irresponsible” decision-making by their executive committee to expand the installation of Oxevision within every psychiatric inpatient bedroom in the Trust. At a cost of at least £2,307,656.40 paid to Oxehealth (as of September 2024), Oxford Health have installed Oxevision across 24 wards and a staggering 37 seclusion rooms and 136 suites, with all contracts extended until 2029. However, as we will outline in this timeline, the decision to expand the installation of Oxevision over three stages appears to have been made despite “damning internal reports” (you can now read this here); overwhelmingly negative feedback from patients, describing the technology as ‘creepy’, ‘unsafe’ and ‘spying’; ongoing issues with the supplier; what appeared to be a major data breach; and a lack of any demonstrable benefit. The decision to expand use of the technology also appears to have occurred without involvement of patients, ward staff, ward management or even the project committee. In fact, the Oxford Health executive committee had not awaited the outcome of reports from earlier stages, or even finished installing the technology, before expanding it to all wards. 

In our complaint, we raise questions about the motivations of Oxford Health’s executive committee to persist with installation of Oxevision, asserting that “this decision making appears so irrational and illogical that it raises questions of whether this was motivated, at least in part, by vested interests.” The complaint calls on Oxford Health to suspend their use of Oxevision and commission an independent review with view to considering full deinstallation of the technology across the trust. You can read the complaint letter here.

This report is written to accompany our complaint to Oxford Health and counter their lack of transparency by presenting a timeline of Oxford Health’s installation of Oxevision as well as their longstanding collaboration with Oxehealth (now called LIO). In part one, we will present a timeline of Oxford Health’s installation of Oxevision across wards between 2021-2025. We draw on numerous documents obtained through Freedom of Information Requests as well as extensive research to outline the numerous challenges the Trust encountered from the beginning. The second part of this timeline will go further back in time to outline the history of Oxehealth/LIO’s origins and support from institutions such as the University of Oxford, the National Institute of Health and Care Research (NIHR), and Academic Health Science Networks (AHSNs – now renamed HINs) as well as connections between key individuals within each.All the relevant documents we have obtained are linked throughout this document and available in this google drive folder.

Summary:

In 2021 Oxford Health signed a business case to install Oxevision on 7 wards. There were persistent issues throughout 2021 and 2022 related to its implementation, including a potential data breach, governance concerns, a “serious incident”, fraught relationships with the supplier, and poor feedback from patients. Despite all this, in February 2023 – prior to having received the outcomes of the first stage of implementation – the Trust executive committee signed a contract to install Oxevision on 9 further wards in 2023/24, and the remaining wards in the Trust in 2024/25. In 2024, all contracts were extended until 2029, before having received the outcomes from the first stage of implementation, and despite ongoing concerns about the technology and limited utilisation on the wards. As of the end of 2025, Oxford Health are continuing to face challenges surrounding their implementation of Oxevision.

2021 – 2022: Oxevision expansion phase one 

Oxford Health first installed Oxevision in six bedrooms within a male acute ward as part of a study funded by the NIHR Oxford Health Biomedical Research Centre (BRC) in 2019, having collaborated on this project since 2016. Following this trial, in March 2021, Oxford Health signed a business case to install Oxevision on the remaining bedrooms on Vaughan Thomas ward and six further wards across the trust: two older adult wards, two female secure wards and two CAMHS wards. The business case was approved on the basis of the anticipated financial benefits of Oxevision, including seeking to reduce the number of health care assistants (HCA) working the nightshift by one staff member on one of the wards, as well as making savings on bank and agency staff for covering observations.

Oxford Health business case pg. 6

Oxford Health business case pg. 13

These aspirations to save money through the use of Oxevision, though seemingly never realised, appear well aligned with the ‘digital agenda’ of the then-CEO of Oxford Health, Dr Nick Broughton, to “harness such technology to free up the time of our clinicians”. However, it is unclear how Oxford Health intended to reduce substantive staff or levels of enhanced observations safely. Moreover, as demonstrated in the table above, references to reducing 1:1 observations and mentions of ‘positive risk taking’ are only listed for female secure and CAMHS wards, raising questions about why this benefit was judged to be inconsistent, and what assumptions (for example, those about the people in these wards)  might underlie such claims.

Despite the bold ambitions to save £709,000, the “damning” project closure report (see here) describes “heated exchanges” with Oxehealth representatives about whether these could be realised – despite them forming the basis of the original business case. It is possible that Oxehealth were concerned they couldn’t follow through on these claims, despite reduction in staff for 1:1 being a central part of their economic analysis and marketing.

Oxford Health Oxevision project closure report (2025) pg. 5

As stated in this passage, the project closure report further raises questions about whether the trust’s business case was written by Oxehealth – which, if this were the case, would seemingly indicate a disregard of the guidance for transparent, evidence-based decision making for public bodies within commissioning and procurement processes. Indeed, the Oxford Health business case includes sections that are identical to other Trust business cases. The project closure document describes:

“Benefit measures must be consistent with the Business case and be able to be supported and reported and “owned” by all Stakeholders.   In the case of the Company’s claim to have authored the Trust Business case there are clear risks of a conflict of interest and governance concerns over this.” – Oxford Health Oxevision Project Closure report pg. 5

This “heated exchange” is just one example; from the beginning, the project is reported to have been beset with delays, and the working relationship with Oxehealth appeared fraught. 

“From the start of the project there has been a need for greater transparency and openness from the supplier.  The company’s rigid adherence to their siloed operating model made progress and discussions difficult as no one person was able to answer and take accountability.” – Oxford Health Oxevision Project Closure report pg. 4

The first incident described in the report involved Oxehealth turning the system on (thus activating cameras in patients’ bedrooms) without having informed Oxford Health management, staff or patients in advance, “caus[ing] immeasurable difficulties for ward staff and loss of credibility in the eyes of patients” (pg.4) and resulting in a need to suspend all system testing. This may constitute a major data breach, however it is unclear whether Oxford Health and Oxehealth reported this to the ICO – as would be required under GDPR. 

Subsequently there were “ongoing concerns over the supplier’s governance and security arrangements” (pg.4). The report continues, “[Oxehealth’s] lack of clarity eventually forced the OHFT to suspend the testing of the system until formal and unequivocable reassurance were received from the company” (pg.4). It is unclear what ‘unequivocable reassurance’ was provided but, inexplicably given this context, Oxford Health proceeded with this relationship with Oxehealth. Important to highlight here is that their data processing agreements with the company don’t appear to be any different from other Trusts’ and involves sharing clear and blurred (yet still potentially identifiable) video of patients in their bedroom with an external company.

Oxford Health’s 2023/4 Data Protection Impact Assessment (DPIA) for Oxevision outlines: 

The Oxevision system captures both clear and anonymised images which are used by staff to support vital sign measurement and to respond to alerts respectively. Clear video data is retained for 24 hours before being overwritten, while anonymised data [including blurred video] is held for the duration of the contract. – Oxford Health Oxevision DPIA 2023/4 (pg. 3)

The DPIA explains that this data is held on Oxehealth’s servers and backed up to Amazon Web Servers. Whilst the DPIA is vague about whether Oxehealth have access to clear video of patients to use in ‘system troubleshooting’, the document does outline: “personally Identifiable Salient Video Data storage is in a secure room with limited keyholder access in a building with 24-hour security guards. This is backed up at Oxehealth until secure deletion” (DPIA pg.9). The document also highlights the risk of “Identification of a patient by an Oxehealth member of staff” (DPIA pg.13). However, we have found no evidence of Oxford Health’s patient posters or leaflets containing details of whether or how video data would be shared with Oxehealth. One alarming poster created by patients and distributed by Oxford Health advises patients ensure they are dressed at all times, with the recommendation (capitals in original) “IT IS IN YOUR OWN INTEREST TO ENSURE YOUR PRIVACY IS NOT INFRINGED AND TO DRESS AND REMAIN CLOTHED ACCORDINGLY.”

Oxford Health Oxevision poster 2025

A further issue in the working relationship between Oxehealth and Oxford Health related to the lack of openness from the supplier:

“A further point of contention was a request for OHFT to be put in touch with other Trusts using Oxevision so we could network and benefit from their learning and experience.  While the company agreed to this, they were reluctant to follow through as indicated by the months of no progress and excuses.  The Company finally responded with a paper from a quasi-NHS network setting out National recommendations, guidance, and best practice on safe use of Vision-based patient monitoring systems (VBPMS).  These incidents reflected the company’s supplier lead “one stop shop” approach which was rooted in almost total autonomy over all aspect of the system supply and operation (from business case, procurement advice to circumnavigate competition tendering, through to installation, testing, live running and finally benefits reporting).  This was at times at odds with the OHFT project-based approach to this procurement which saw the customer acting and exercising much greater control and influence over all the processes. The company’s rigid system design also meant that requests for change were unable to be accommodated. These were “parked” by the supplier on their development log for some future time.  Successful business relationships are built on trust, and this was not evident in the company’s responses and approach.” – Oxford Health Oxevision Project Closure report (pg.4)

The project closure document cites issues and ‘debates’ around matters of consent. Originally, Oxford Health planned to implement an opt-out consent process, as had been used on Vaughan Thomas ward, whereby Oxevision would automatically be turned on for all patients, without explicit consent, and only turned off if patients object. Shortly after Oxevision was activated on wards, this consent policy was changed to require patients to explicitly opt-in in November 2022.

“Poor participation also impacted upon some decisions that were made by the group.  This is best illustrated by the late reversal of the decision on patient consent.  This reflected badly upon the quality of the discussion and debate that led to the original decision and was wasteful of project time and resources in revising leaflets, procedures, and policy material to effect the change later. There needs to be a much stronger focus within the Trust of holding stakeholders to account in the timely and effective discharge of their responsibilities”. – Oxford Health Oxevision Project Closure report (pg.5)

This consent policy would come to create issues for Oxford Health from the beginning due to high numbers of patients not giving consent for the use of Oxevision, and encouraging other patients to also refuse this. The Early Insight Report, published May 2023, highlights extensive concerns about the technology amongst patients, confusion from staff, and low usage of the system where patients did not opt-in to use the system: “Across the evaluation period at any one time a significant number of rooms did not have Oxevision switched on. This means that staff could not fully change their ways of working on the ward or maximise the benefits of using Oxevision. Therefore, the benefits they identified may be underemphasised.” – Oxford Health Oxevision Early Insights Report pg.4

The Early Insights report further outlines:

“Other wards appear to have more difficulty communicating to patients and carers. Conversations are either not part of routine or unsuccessful. Staff report they are unsuccessful because they lack confidence to explain the system, conversations focus heavily on ‘a camera’ in their room and with certain client groups, patients can heavily influence each other.” – Oxford Health Oxevision Early Insights Report pg.15

We are concerned that the passage above promotes an underemphasis of the presence on a continuously-recording camera, as this could lead to more patients ‘consenting’ to its usage. Indeed, this approach of understating the video camera inherent to the Oxevision system seems to have been central to the design of Oxevision from the very beginning with Laura Cozens, head of patient safety at Oxehealth, describing that the camera is deliberately hidden behind a black panel to reduce patients focusing on the camera. A staff member on a CAMHS ward said:

“We thought it was an opting out system, so everyone was already opted in and then it got flipped the other way. It was oh, no, people have to opt in to use the system, which I suppose for me felt a little bit disappointing because then we would have captured more patients… It’s a great tool, but it almost feels like we’ve been limited in how we can use it” Highfield Ward, Clinical Nurse Lead [CAMHS ward] (Early insights report pg.20)

“We thought when we got a new group of young people that we were going to have more young people agreeing to it and it was going to be much easier and it’s going to be more widely implemented. Then we just keep having young people just refusing, refusing it” Highfield Ward, Clinical Nurse Lead [CAMHS ward] (pg.20)

Prior to the ‘go live’ of Oxevision in late 2022, concerns were raised at board meetings. In March 2022, questions about Oxevision raised by a patient representative were not addressed, instead opting to address this outside the Board Meeting in a less public forum. 

Oxford Health board meeting minutes March 2022 (pg.14)

In June 2022, concerns about the technology were noted in relation to media attention following articles in the Guardian in December 2021 and March 2022. However, the Oxford Health Exec board determined that concerns were largely due to “a process of implementation which has not fully involved patients and families which has led to a poor experience”. This is despite the previously mentioned privacy concerns and the fraught supplier relationship the Trust were encountering. By foregrounding difficulties of process and implementation, this framing seems to ignore more substantial issues at the heart of the product itself: the privacy concerns inherent to installation of cameras in bedrooms. We believe that simply ‘involving’ families and patients is not sufficient to address this. 

Oxford Health Council of Governors Oxevision Implementation project update June 2022 pg.3

The same report, presented to the Council of Governors, claims that patients have been involved in the process. However, from the information we have (below), this appears to have been limited to the design of posters. The suggestion that Oxevision can best be demonstrated once “physically installed” further highlights the lack of patient involvement within decision-making prior to the installation of Oxevision. 

Oxford Health Council of Governors Oxevision Implementation project update June 2022 pg.2

Despite all the issues Oxford Health encountered with the technology, the supplier, and the implementation itself, the process to install Oxevision continued. Oxevision ‘went live’ on wards between 5th August 2022 and 29th December 2022 – a considerable amount of time after the original plans to install this within the 2021/22 financial year. 

In November 2022, the Trust’s observation policy was updated following a “serious incident” outlining that “CCTV/monitors” [Oxevision] are prohibited to be used for level 3 (enhanced or 1:1) observations. In practice, it is unclear how a policy update would address this issue or provide any real safeguard against staff from using Oxevision in such a way, especially when the Trust’s own business case is built on the premise of its value in reducing 1:1 observations (pg.6).

Oxford Health “The Safe and Supportive Observations of Patients at Risk” policy, updated December 2022 (pg.2)

2021-2023 ‘Benefits realisations’ from implementation phase one

The chronology of our timeline becomes confusing at this point. Whilst the ‘benefits realisations’ and project outcomes from the first stage of installation of Oxevision were reported in May 2023 (qualitative report) and July 2024 (quantitative report), the Executive committee had already made the decision to expand it to the remaining wards in the Trust in February 2023 and extend all contracts for a further five years in April/May 2024. Therefore, whilst our timeline will now outline the Early Insights Report and Quantitative outcomes, it is important to note that Oxford Health were already progressing with their installation of Oxevision across the Trust at this stage. 

Early Insights Report

In Stop Oxevision’s evidence to the Lampard Inquiry in 2025, we highlighted persistent patterns of Oxehealth manipulating figures to present a more favourable picture for use in their marketing materials. For instance, selectively excluding patient responses from statistics or conflating a decrease with a relative change. Similar issues were also noted by the Oxford Health project team who described Oxehealth’s “one stop shop” approach to controlling each aspect of the Oxevision implementation and evaluation.

“The Early Insight report is highly prized and valued by the company as it forms the bedrock of their sales and marketing drive.  They therefore guard and defend this area fiercely.  During discussion of the survey forms used by the company it was found that the questions being asked where “leading” presumably to improve survey scores.  These questions were altered by the Trust. The Trust also removed the questions on use of the system to alter observations levels on the ward to effect benefit” – Oxford Health Oxevision Project Closure Report (pg.5)

In addition to the “leading questions”, in the Oxford Health Early Insights Report, which is Oxehealth branded, 6 responses were discarded as the patients had opted not to have Oxevision on. This is a significant methodological issue, as these patients’ experiences remain important in understanding the overall experience of Oxevision, especially as the technology continues to glow red in the rooms of all patients, regardless of whether Oxevision is on or not. This was described by one patient as: “its creepy when I look up and see its red eyes looking at me. It feels like a monster is looking at me in the night” (pg.27).

The document is presented in two parts which paint starkly different pictures. The first 17 pages appear to attempt to present a more positive picture from the data, however, from page 18 an appendix is presented to include additional patient quotes and details from focus groups held by Oxford Health staff. Many of the accounts provided by patients are harrowing: 

“Some of them the family don’t understand because they can’t see it. They think you’re spying on their loved one. You know, you’ve got a camera in their room. But they just hear this camera and that’s it, they’re off on one. You’ve got a camera on my father why have you got a camera on a patient who’s paranoid. Some of the patients were less than happy that you’re putting cameras in their rooms, they just did not understand, did not want to know the benefit that they’ve perceived as a camera, why are you spying on them. So for a patient that’s psychotic and they coming in here, you’re adding to the psychoticness by adding a camera into the room they already think they’re being spied on now she thinks we can actually spy on them” (staff nurse) (pg.23)

Patients reported that Oxevision makes them feel unsafe, and described it as creepy and an infringement on their privacy. The report states: “7 patients talked about their privacy and all 7 thought that the system negatively impacted their privacy. Not knowing when you were going to be viewed, feeling like you are being watched all the time, feeling like you’ve done something wrong as you aren’t allowed any privacy were all shared by patients” (pg.25). Additional patient quotes included:

“I don’t have it on. Its not safe” (pg. 26)

“The cameras should go off. Should have your privacy. No one wants to be watched. Its punishment. They didn’t tell me much about it ” (pg. 26)

“it feels like an invasion of privacy” (pg. 26)

“its creepy, that people are watching you” (pg. 26)

Patients, staff and carers expressed concerns about the system making patients more unwell:

“It can make you more unwell. When I am unwell I think all cameras are watching me and that people can hear me through them. I used to talk to the cameras on a ward that had CCTV. It might make you paranoid and make your delusions worse.” (pg.29).

There were also concerns about it impacting patient care and that it was just used for cost savings: 

“if you are crying, or upset, a camera isn’t going to pick up that upset and offer you comfort” (pg.27)

“I don’t like the box but I have it on. Communication is more valuable, More technology used means less communication directly. It will be abused. Cant change to do everything remotely. Care needs the personal touch and never stop the people contact. That’s so important” (pg.26)

“Its not necessarily helping anything, just making it cheaper for them” (pg.26)

Patients reported the system being turned on without their consent:

“I know what it does and I don’t like it. They said it wasn’t on but it was. They use it as an excuse to sit in the office all day and not do checks. They didn’t listen when I asked for it to be switched off” (pg.26)

“staff tried to trick me and turn it on when I don’t want it” (pg.26)

Some quotations suggest that patients have been misinformed about Oxevision and the fact that it is constantly monitoring. This is especially concerning in the accounts where patients appear to have ‘consented’ to having Oxevision on without having been provided with accurate information. 

“It’s a good thing that its on. I want to know what goes on in my room. They gave me a leaflet. I know it takes a picture for a few seconds” (pg.26)

“somebody told me it records your conversations – Is that what it does? I have the box on. I haven’t had a leaflet” (pg.26). 

“I didn’t get a leaflet or any information” (pg.27).

“What if you are changing when it decides to take a video of you?” (pg. 27)

“I am worried about it coming on when I have come out of the shower and am getting dried and putting cream on. I don’t know how much staff can see me.” (pg.28)

“Staff don’t give clear information about it. The first information was wrong and then the Matron came and told us something different. Nobody seems to know so it is hard to understand how much it can see and how it works.” (pg.29)

Another response seems to suggest patients can see the screen through the window into the office – something that has also been reported across multiple other Trusts: 

“It counts how many minutes you are in your room and how long you are out of your room. You can see this on the screen through the window in the nurses office. I don’t like it monitoring everything I am doing.”(pg.29)

Another patient asks the very reasonable question: “Would you like a camera in your bedroom at home?”(pg.29). 

Despite this concerning feedback from patients, family and staff, Oxford Health continued to persist with the implementation of Oxevision, raising questions as to why they made such a decision. 

Quantitative measurements / insights report 

In July 2024 the quantitative report from the first stage of the project was finally published. The report outlines some small changes in the length of time taken to complete observation rounds, however it appears one of the wards estimated the time and was excluded. 

Oxford Health Oxevision Quantitative Analysis Report July 2024 pg. 5

Given many patients were not providing consent to the use of Oxevision, it is unlikely to change the time taken to conduct observation rounds – we suggest that, if anything, the task of checking some patients in person and others on the tablet might actually add time (for example, the work that must be done in checking records as to  who is using Oxevision and who isn’t). Furthermore, 15 seconds appears an astonishingly short amount of time to safely check that patients on a secure mental health ward are safe and well. Treating observation processes like a race clearly risks concerns being missed and a lack of engagement with patients who may be awake, distressed and struggling to sleep.

Beyond these crude timings of observations, the report provides no real evidence of any demonstrable benefit of Oxevision in relation to incidents or staff time. This issue is compounded by a “cyberattack” – a significant concern in itself – meaning data was missing. Combined with the limitations of this unreliable methodology, there is no evidence of any demonstrable benefit of Oxevision within this report. 

Oxford Health Oxevision Quantitative Analysis Report pg.15

As previously outlined, despite numerous challenges encountered and lack of any clear benefit, by the time the quantitative report was produced, the executive committee had already committed to installing Oxevision on all wards in the trust and paying for this until 2029. Again, this raises questions as to why this continued regardless.

2023-2024 – Second phase of installation 

In early 2023, an ‘end of project report’ was drafted to summarise the initial installation of Oxevision. The document, first dated 9th Feb, was signed off on the 31st May 2023 alongside the Early Insights Report dated May 2023. Despite all the challenges encountered, limited usage of Oxevision and concerns raised by patients, in addition to a “serious incident”, a decision was made by the executive committee to extend the rollout of Oxevision over two further phases across 2023-2025 covering all wards within the Trust. “Executive Board approval was given on the 27 February 2023 to extend the roll out of Oxevision to a further nine Inpatient Wards in FY (FY 23/24)” (Oxevision project closure report pg.7). 

Oxford health Oxevision project closure report pg. 6

Delays with the second phase were noted due to a recurrence of the issues faced in the first stage of installation, in addition to ‘policy changes’. The report does not clarify what policy changes were made, however, this likely related to a decision, made between 2023 and 2024, to change from using Oxevision 24 hours a day to only having it on at night. There were also issues related to defective cameras. Further challenges were encountered with engaging wards and what is described as a “‘culture of silence’ among trust employees” (pg.9)

Oxford health Oxevision project closure report pg. 9

Following the first stage of implementation, the project manager and clinical lead for the Oxevision implementation conducted an audit between May and June 2023 to understand how it was being used across the 7 wards. Once again, although this audit was vital for considering the impact of the installation, the executive committee did not await its outcomes before signing another contract and investing further in the technology.  

The audit identified major issues including a lack of information and signage for patients, there were issues with consent and in “most cases, the system’s operational status did not align with recorded patient consent”, and patients weren’t aware of the system or hadn’t consented yet it was turned on regardless. Staff weren’t aware of the operating procedure and the tablets purchased for the wards weren’t being used. 

Oxford health Oxevision project closure report pg. 9

A second audit was then conducted between August and September 2023 which identified many of the same challenges. Despite this, the rollout of Oxevision to additional wards with the exec committee standing firm to their decision.

Around this time, Stop Oxevision first published our open letter raising concerns about the use of Oxevision at Trusts, including Oxford Health. In the November 2023 Board meeting an update about Oxevision was provided by Karl Marlowe (Oxford Health Chief Medical Officer, introduced above) who noted that despite “ethical questions” and issues raised, the Trust were continuing with the installation of Oxevision, with him reasoning that ‘it was better to have it than not’ and ‘other trusts use it’. This appears to reflect an aim to expand Oxevision based merely on hypothetical benefits that are entirely at odds with what the evidence from Trust’s own implementation efforts were reflecting, as well as that of their audits and ‘early insights’. 

Oxford Health Board of Directors meeting November 2023 pg.334

The phase 2 wards went “live” over the period between 5th February 2024 to 18th June 2024. However, at this time, according to the Trust’s usage reports, Oxevision was still being used minimally by the wards it had first been installed on with just 50 ‘vital signs attempts’ on Kestrel Ward that month.

Oxford Health Oxevision usage report Feb 2024

In April 2024, despite the low usage of the technology; ongoing issues with its implementation, poor adherence to policies (as illustrated in Oxford Health’s own audits), and longstanding concerns within the Trust, the executive board approved a further rollout to nine wards, introducing Oxevision into all wards and seclusion rooms within the Trust (with the exception of one pre-discharge ward). However, the project closure report suggests that this expansion had already been agreed in 2023. The report further outlines that the opportunity was taken to combine all contracts, “reducing the need to renegotiate contracts in 2026” (pg.11) with some incentives offered by Oxehealth, as well as compensation for the project in phase two. A 5 year contract was signed, commencing 1 May 2024. 

Importantly, this decision was made before the quantitative report from the first stage of implementation had been finalised and created an overlap between phases two and three of the expansion. This would have prevented opportunities to consider whether there was evidence to suggest that extending existing contracts was appropriate.  

Oxford health Oxevision project closure report pg. 11

The installation of Oxevision on the second set of wards finished in June 2024. However, the technology was still being used minimally, if at all, on the wards it had been newly installed on or installed for some time. 

Oxford Health Oxevision usage report June 2024 

Between October 2024 to January 2025, a third Oxevision audit was conducted to address earlier concerns and consider the implementation of Oxevision on the ‘phase two’ wards. A summary of this third audit is provided as follows: 

Oxford health Oxevision project closure report pg. 10

The passage above references a “need to instil in wards the motivation and drive to follow policies and procedures to prevent standards dropping”. The vague reference is extremely concerning given a failure to follow procedures may pose significant risk to patients, and may breach their Human Rights (e.g. if cameras are used without patients’ knowledge or consent). 

During this time, the wards were still minimally using Oxevision. Oxehealth added a % time switched on record to the usage reports indicating that, on some wards, Oxevision was turned off most, if not all, of the time.

Oxford Health Oxevision usage report December 2024 

Concerningly, some of the seclusion rooms have the cameras turned on 100% of the time, despite the vital signs function being accessed very infrequently, if at all. This means patients would likely still be being recorded, with blurred video of them shared with a private company, but without staff actually using the elements of the technology that are supposedly for the patient’s ‘wellbeing’. This issue is compounded where CCTV is used within Oxford Health’s extensive number of seclusion rooms, in addition to Oxevision. Nevertheless, the policy is that Oxevision is always turned on and patient consent is ‘not required’. 

“The use of Oxevision during a seclusion episode does not require consent from the patient. Oxevision is a valuable addition to ensuring the patient is safe during the period of a seclusion episode.” – Oxford Health Oxevision policy October 2024 (pg.12)

2024 – 2025 – Phase three of installation 

The third and final stage of installation was between November 2024 and August 2025 across nine further wards. During this time further issues were faced including, “issues like server connectivity and new fibre optic links, air conditioning upgrades, adding cost and complexity” (Oxevision project closure report pg.12). These infrastructure costs are likely to have been expensive. Air conditioning is likely required to cool servers, whilst the fibre optics are likely required in relation to the ongoing issues with Wi-Fi connectivity and system issues with Oxevision. This reflects spiralling costs, and highlights the importance of recognising that the figure of approx. £2,307,656.40 paid to Oxehealth is just a fraction of the real cost invested into the technology, including installation costs and infrastructure costs (such as installing data servers and the air conditioning needed, as well as fibre optics; electricity costs; and the salaries of the project management team to reflect the added workload this project required). 

At the January 2025 Board meeting there was some discussion of patient consent for the use of Oxevision. The chief medical officer, Dr Karl Marlowe, seems to reinforce the use of Oxevision and overlook the trust’s own issues with cameras being turned on without patients’ consent. 

Oxford Health board of directors meeting minutes January 2025 (pg.360)

Following the publication of the NHS England ‘Digital Principles’ in February 2025, a further report presents Oxford Health’s summary of how they are purportedly meeting these. The document begins with recognition of national concerns, including those raised by Stop Oxevision, as well as national media coverage and calls from Rethink and the Royal College of Psychiatrists to pause use of Oxevision.

The document is structured according to each ‘Principle’ and cites the Trust having conducted audits; however, it fails to provide details of the audits or the poor patient feedback and challenges encountered – seeming to be no more than a ‘tick box’ exercise. Some passages from the document are taken directly from a document Oxehealth wrote following the publication of the NHS England ‘digital principles’ outlining how trusts can show that Oxevision supposedly adheres to them. The document not only seemingly fails to outline how the Trust’s use of Oxevision adheres to these principles, it also fails to outline any clear benefit of Oxevision or the rationale for such extensive rollout of the equipment. 

Oxford Health Oxevision review April 2025 pg. 6

Furthermore, the document details a decision to turn off the clear recording function of Oxevision meaning clear video is viewed when taking observations but is not stored. However, 24 hours of blurred video is still recorded and shared with Oxehealth. 

“The clinical workstream have requested that this functionality is disabled, the rationale for this is that clinical teams working on wards feel that this is an infringement on the privacy and dignity of our patients and that consent to having the system in use would be improved.” – Oxford Health Oxevision review April 2025 pg. 7

Ultimately, even with the clear video retention disabled, we argue that Oxevision remains an “infringement on the privacy and dignity of [Oxford Health] patients”. Nevertheless, despite the document promising that not retaining recordings will address privacy concerns, in September 2025 the project board meeting minutes cite ongoing issues with turning off the recording feature. This was apparently due to challenges with the functionality of Oxevision not allowing recording to be selectively disabled. Subsequent meeting minutes state that 24 hour recording should be turned off across the Trust, however it is unclear whether this has been actioned.

September 2025 Oxevision/LIO project board meeting minutes pg.2

2025

The 2025 board of directors’ meeting minutes consistently outline that their “top Directorate priorities and efficiencies” include “continu[ing] to support the implementation of Oxevision across the Trust” (May 2025 meeting minutes pg.67). Indeed, through 2025 Oxevision was still being installed on wards with the final installation going live in October 2025. This is despite the mounting concerns and media coverage surrounding Oxevision, as well as the scheduling and rescheduling of hearings to the Lampard Inquiry in relation to Oxevision. Furthermore, issues were still being encountered with the use of Oxevision on wards. In the 20th October 2025 project board meeting minutes, ongoing concerns are noted about inconsistencies in the use of Oxevision and ‘inappropriate use’.

Oxford Health Oxevision project board meeting minutes October 2025 pg.2

As mentioned previously, at some stage between 2023-2024, a decision was made to switch to only using Oxevision on wards at night time. Plans in 2025 considered reverting to using this 24 hours a day across wards. However, many challenges appear to have been encountered through this process with one ward having all patients on the ward not consenting to the use of Oxevision. In July 2025, it was noted that using Oxevision within the day resulted in a reduction of face-to-face interactions especially on the CAMHS ward.

July 2025 Oxevision/LIO meeting minutes

As has been shared in the accounts of numerous patients, this illustrates what we consider to be an integral risk of Oxevision and other video-based surveillance technologies in reducing interactions between staff and patients, posing potentially grave risk. Despite noting these issues, the meeting minutes above do not provide any clarity about how Oxford Health intends to mitigate these risks. 

Over four years since Oxford health first installed Oxevision, they are continuing to encounter issues with the technology and appear to lack a coherent plan for how to the mitigate significant risks associated with it. At the time of writing, it is unclear whether Oxevision has now been installed on one final ward, Cotswold House, an eating disorder unit in Wiltshire. None of the documents we have reviewed provide evidence of any clear benefit of the use of Oxevision. 

Conclusion 

This report has detailed multiple, serious concerns around the decision making pertaining to the implementation of Oxehealth technology on behalf of Oxford Health NHS Foundation Trust. As we have demonstrated, Oxford Health have installed a novel, highly intrusive technology in all wards and seclusion rooms at great expense. The technology’s adherents, both within the Trust and within its manufacturing company Oxehealth, claimed it would provide groundbreaking improvements to patient safety, to staff capacity, and to reducing costs. It is unclear that any of these benefits have materialised. Rates of usage have remained low across the 4-year implementation period, with rates of use in individual wards seemingly decreasing over time rather than increasing. There is evidence that policies regarding its use are followed inconsistently, and the Trust’s relationship with Oxehealth appears to have been difficult from the beginning.

Repeatedly, the fundamental concerns of patients and carers appear to have been dismissed, minimised, and erased – re-framed as issues of ‘implementation’. Yet the Trust’s evaluation clearly echoes the concerns being raised by patients and patient advocacy groups in wider public discourse – particularly when used on inpatient mental health wards, the potential for cameras to confound or worsen symptoms and experiences of psychosis. Patients, families, and even Trust staff are deeply alive to the infringement of privacy the technology poses; the seriousness of such concerns is reflected not only in comments made in the project’s evaluation, but also in the low rates of uptake and staff reporting difficulty securing patient consent. 

Oxevision, which involves placing constantly-recording video cameras in patient bedrooms, is a restrictive practice, yet the documents provided by Oxford Health fail to demonstrate clear benefits of the technology, proportionate to its level of restriction or indeed cost. Contracts were extended before the technology had even been installed, preventing time for careful consideration of whether Oxevision represented an appropriate implementation of restrictive practices or use of money. This raises serious questions of why Oxford Health’s executive committee have greenlit its expansion at every stage, without evidence that they had considered the outcomes of this investment. Indeed, as we question in our complaint, “this decision making appears so irrational and illogical that it raises questions of whether this was motivated, at least in part, by vested interests.” In the context of such uncertainties, the second, forthcoming, part of this timeline will go further back in time to consider the connections between Oxford Health (and key individuals within the organisation) and Oxehealth through institutions including the University of Oxford, the NIHR Oxford Health BRC and the Oxford Academic Health Science Networks.